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HomeMy WebLinkAboutHomestead_Kell (4) INDIANA SALES DISCLOSURE FORJI SDI:ID 51)01D 1807867 Paget D.PREPARER • - - - - ' Britany N Barnes Searcher Preparer of the Sales Disclosure Form Title 226 W.Broadway Broadway Title Inc Address(Number and Street) E-mail E.SELLER(S)/GRANTOR(S) -• - • - • •William E.York Paula Gayle York 0 I I f I key-L5 Seller 1-Noire as appear)on comervme document Seller 2-Name as appears on conveyance document 426 E.Oak 426 E.Oak Address(Number and Street) Address(Number and Street) Princeton, IN 47670- Princeton,IN 47670- Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as required by las, and is prepared in accordance 6-1.1-5. Real Property Sales Disclosure Act". w2. ,v . ce,a ' 4 L Signature of Seller 2 / ruse of Seller 12.4e. � rr /a. - ofZ2.-/j 3LlLA - 4 Lc- �:t Isar /s Pr_•-sN-.,r rr c,.a.• c;__bra.„-.,ino•vvm n.;••,,..'„mr nrcon.7- c:,,.nr'r•uvv.nA-m. F.BUYER(S)/GRANTEE(S)-APP ICATIONFORPROPERTYTAXDEDUCTIONS-'IDENTIFY'ALL! ( T 'PLY Kaela Kell ;_ i.! conveyance Bureri-Nome as appears on conveyance document Buyer 2-Name as appears on conveyance•• ,.' 203 S.Indiana St. Address(Number and Street) Address(Number and Street) MAY 28 2015 Hazleton,IN 47640- THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR'Ems PROPERTY. IDENTIFY'ALL OF THOSE THAT APPLY. AUDITOR YES NO CONDITION I YES NO CONDITION B ❑ I.Will this property be the buyer's primary © ❑ 3.Homestead residence? Provide complete address of primary ❑ ❑ 4.Solar Energy Heating/Cooling System residence,including county: ❑ 203 5.INDIANA ST 5.Wind Power Device Addrecc(Number and Street) ❑ ❑ 6.Hydroelectric Power Device Hazleton,IN 47640 GIBBON ❑ © 7.Geothermal Energy Heating/Cooling Device Ciry.State ZIP Code Canty ❑ ❑ 2. Does the buyer have a homestead in Indiana to be ❑ © 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ ❑ 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information including county: below. Please see instructions for more information. Not available in all counties.) Address(Number and Street) City,State ZIP Code County Z'6,-o a `59 0300, ono .3/S a/9 Primary property owner contact name E-mail